[面部黑色素瘤的颅内扩散：三叉神经通路]
[Intracranial spread of a melanoma of the face: the trigeminal pathway].
作者信息
Alix T, Boutet C, Caquant L, Mohammedi R, Barral F-G, Seguin P
机构信息
Service de chirurgie maxillofaciale, plastique et esthétique et de stomatologie, hôpital Nord, 42055 Saint-Etienne cedex 02, France.
出版信息
Rev Stomatol Chir Maxillofac. 2008 Jun;109(3):172-4. doi: 10.1016/j.stomax.2008.03.003. Epub 2008 Jun 2.
INTRODUCTION
The intracranial evolution of cutaneous melanoma is usually due to metastases. Neurotropic invasion mainly concerns the trigeminal and the facial nerves. The melanoma is a rare entity among neurotropic tumors.
OBSERVATION
A patient presented with a desmoplastic melanoma of the lower lid, complicated by a perineural extension to the cavernous sinus and the mandibular nerve via the maxillary nerve.
DISCUSSION
This neurotropic evolution should be carefully monitored when close to a nerve. Extensive surgical excision including peripheral nerves in the vicinity of such tumors is recommended. MRI should be performed when a motor or sensitive disorder appears in the course of a desmoplastic melanoma.
引言
皮肤黑色素瘤的颅内演变通常是由转移引起的。嗜神经侵袭主要涉及三叉神经和面神经。黑色素瘤在嗜神经肿瘤中是一种罕见的实体。
病例
一名患者出现下睑促纤维增生性黑色素瘤，并发通过上颌神经向海绵窦和下颌神经的神经周围蔓延。
讨论
当靠近神经时，这种嗜神经演变应受到密切监测。建议进行广泛的手术切除，包括此类肿瘤附近的周围神经。当促纤维增生性黑色素瘤病程中出现运动或感觉障碍时，应进行磁共振成像检查。
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